1. Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland , USA
2. Department of Medicine and Therapeutics, Aberdeen University, Aberdeen, UK
3. Intramural Research Support Program, Science Applications International Corporation Frederick, National Cancer Institute-Frederick Cancer Research and Development Centre, Maryland , USA
4. Department of Medicine and Therapeutics, Western Infirmary, Glasgow, UK
5. Division of Basic Sciences, National Cancer Institute, Frederick Cancer Research and Development Centre, Maryland, USA
6. Division of Cancer Epidemiology and Prevention, Cancer Centre and M. Sklodowska-Curie Institute of Oncology, Warsaw, Poland

Correspondence to: Correspondence and requests for materials should be addressed to E.M.E. (e-mail: Email: elomare@mail.nih.gov).

Abstract

Helicobacter pylori infection is associated with a variety of clinical outcomes including gastric cancer and duodenal ulcer disease¹. The reasons for this variation are not clear, but the gastric physiological response is influenced by the severity and anatomical distribution of gastritis induced by H. pylori. Thus, individuals with gastritis predominantly localized to the antrum retain normal (or even high) acid secretion², whereas individuals with extensive corpus gastritis develop hypochlorhydria and gastric atrophy³, which are presumptive precursors of gastric cancer⁴. Here we report that interleukin-1 gene cluster polymorphisms suspected of enhancing production of interleukin-1-beta are associated with an increased risk of both hypochlorhydria induced by H. pylori and gastric cancer. Two of these polymorphism are in near-complete linkage disequilibrium and one is a TATA-box polymorphism that markedly affects DNA–protein interactions in vitro. The association with disease may be explained by the biological properties of interleukin-1-beta, which is an important pro-inflammatory cytokine⁵ and a powerful inhibitor of gastric acid secretion^{6, 7}. Host genetic factors that affect interleukin-1-beta may determine why some individuals infected with H. pylori develop gastric cancer while others do not.